New Mexico Administrative Code
Title 7 - HEALTH
Chapter 20 - MENTAL HEALTH
Part 11 - CERTIFICATION REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH SERVICES
Section 7.20.11.29 - TREATMENT FOSTER CARE SERVICES

(a) are at risk for placement in a higher level of care or are returning from a higher level of care and are appropriate for a lower level of care; or

(b) have complex and difficult psychiatric, psychological, neurobiological, behavioral, psychosocial problems; and

(c) require, and would optimally benefit from, the behavioral health services and supervision provided in a treatment foster home setting.

(a) have successfully completed treatment foster care services level I (TFC I), as indicated by the treatment team; or

(b) require the initiation or continuity of the treatment and support of the treatment foster family to secure or maintain therapeutic gains; or

(c) require this treatment modality as an appropriate entry level service from which the client will optimally benefit.

(a) an effort is being made to reunite siblings; or

(b) a change of treatment foster home is clinically indicated, as documented in the client's record by the treatment team.

(a) Treatment planning: Under supervision, and in coordination with the rest of the treatment team, the treatment coordinator:

(b) Contact with client: The treatment coordinator has a private face-to-face visit with the client within the first two weeks of placement, and at least twice monthly thereafter for TFC I clients and once monthly for TFC II clients. These contacts are conducted both in-home and out-of-home.

(c) Contact with treatment foster parent(s): The treatment coordinator has a face-to-face interview with the client's treatment foster parents within the first two weeks of placement and at least twice monthly thereafter TFC I clients and once monthly for TFC II clients. The treatment coordinator has a minimum of one phone contact with the treatment foster parent(s) weekly. Phone contact is not necessary in the same week that face-to-face contact has been made.

(d) All contacts are documented in the client's record and include a summary related to the treatment plan, significant events and the communications between treatment coordinator, client, treatment parent(s) and the biological/adoptive family. All documentation includes the date, time, location of the contact, and names of persons present.

(e) Support of the client's relationship with his or her biological/adoptive family: The treatment coordinator supports and enhances the client's relationship with his or her family to the extent determined by the treatment team. The treatment team reviews any restrictions at the time of the writing of the comprehensive treatment plan or at the time the restriction is imposed. The treatment coordinator documents in the client's case record the reason(s) for any restriction, and the treatment team's involvement. Thereafter, the restriction is reviewed at least every 30 days and documented in the treatment plan review.

(f) Assistance to treatment foster parents: The treatment coordinator assists the treatment foster parents in the implementation and development of treatment strategies, including goal-setting and planned interventions. This assistance is done through the following:

(g) Community liaison and advocacy: Based upon an assessment of the client's and biological/adaptive family's needs, the treatment coordinator advocates for and coordinates the provision of community-based services, as related to identified goals, and provides technical assistance to community providers as needed to maximize the utilization of services by the client and family.

(h) A treatment coordinator is physically available within 60 minutes of a treatment foster home so that quality of care, appropriate supervision and timely responsiveness to the treatment foster family are possible.

(a) The clinical supervisor is responsible for supervising ongoing treatment planning and implementation of the treatment plan for each client. The clinical supervisor evaluates progress in treatment and signs the treatment plan documents.

(b) The clinical supervisor provides coordination and back up coverage allowing for 24-hour on-call crisis intervention services for treatment parents, clients and their families.

(c) The clinical supervisor monitors the case load of each treatment coordinator, and monitors each treatment coordinator in fulfilling his/her responsibilities. The maximum number of treatment foster care Services client(s) that maybe assigned to a single treatment coordinator shall not exceed eight. Case loads are reduced based on case complexity, travel times and non-direct service times. The actual number of clients in a single case load is based upon the ability of the treatment coordinator and/or agency to meet all applicable regulations as well as on the following considerations:

(a) Therapists, treatment coordinators, and other professional staff participate in knowledge/skill based pre-service training relevant to the services provided including:

(b) Professional staff who can provide verifiable documentation of previous training in one or more of the above areas are not required to repeat the training if the staff and the clinical supervisor agree in writing as to which specific training is equivalent and therefore not required. This exception does not apply to training regarding an agency's policies and procedures.

(c) All professional staff attend annual, ongoing professional development/ training relevant to the agency's treatment foster care model and to their individual job responsibilities.

(a) hold a current and valid license as treatment foster parent issued by an agency licensed by the department as a child placement agency. No home can be licensed for treatment foster care services until any previous foster care license is surrendered to the issuing agency;

(b) have signed a release of information that permits the department to share with the treatment foster care services agency a summary of any substantiated complaints involving abuse/neglect pertaining to the prospective treatment foster family;

(c) have signed a release to allow the agency to read prior foster home and prior treatment foster home records that exist through any previous foster home licensure or certification;

(d) understand the placement in treatment foster care services as temporary, except when adoption by the treatment foster parents has become the permanency plan;

(e) have access to reliable transportation, and when driving a car have a valid New Mexico driver's license and liability insurance;

(f) have read, expressed understanding of, and agreed in writing to fulfill the requirements and responsibilities of a treatment foster parent;

(g) prior to hiring or contracting with prospective treatment foster parent(s), the agency documents that it has requested and reviewed the prospective parent(s)' substantiated reports of abuse/neglect, if any, and previous foster-parent records, if any, and determined that such history does not disqualify the prospective parent(s) from becoming treatment foster parent(s); the agency will inquire about any previous treatment foster care services or regular foster care experience applicant families may have had.

(a) All treatment foster parents receive 40 hours of training, at least 30 hours of completed prior to placement of client(s). Any remaining hours are completed within two months of first placement. The training, at a minimum, includes:

(b) Treatment foster parents who can provide verifiable documentation of previous training in one or more of the above areas are not required to repeat the training if the staff and the clinical supervisor agree in writing which specific training is equivalent and therefore not required. This exception does not apply to training regarding an agency's policies and procedures.

(c) Twenty-four hours of in service training is required annually after receiving a client for placement. The 24 hours may include:

(a) Treatment planning: Treatment foster parents actively participate in the treatment planning process and implement specified provisions of the treatment plan.

(b) Treatment foster parents work with the treatment team to maximize the likelihood that all services are provided in a culturally competent and culturally proficient manner.

(c) Contact with the client's family: Unless contra indicated in the client's treatment plan, or by court order, treatment foster parents assist the client in maintaining contact with his or her family, and actively work to support and enhance those relationships. When reunification with the client's family is planned, the treatment foster parents work in conjunction with the treatment team toward the accomplishment of the reunification objectives outlined in the treatment plan.

(d) Permanency planning assistance: The treatment foster parents assist with efforts specified in the treatment plan to meet the client's permanency planning goal(s).

(e) Record keeping: The treatment foster parents systematically record information and document client behaviors/activities and significant events related to the treatment plan. Documentation occurs on a weekly basis at a minimum, and more often in response to the occurrence of significant events. Daily logging is preferable.

(f) Agency contact: The treatment foster parents keep the agency informed of the occurrence of significant events. Daily logging is preferable.

(g) Confidentiality: Treatment foster parents maintain agency standards of confidentiality.

(h) Incident reporting: Treatment foster parents report all serious incidents to the agency, consistent with agency policy and certification requirements.

(i) Availability: At least one treatment foster parent is readily accessible at all times and is able to be physically present, if necessary, to meet the client's emotional and behavioral needs; e.g., a treatment foster parents responds if the school requires immediate parental attention. A single treatment foster parent may not schedule work hours when a client is normally at home.

(j) Care and supervision: Treatment foster parents ensure that proper and adequate supervision is provided at all times. Guardians ad litem, court-appointed special advocates, and CYFD employees may meet privately with clients as necessary. Clients are not left in the care or unsupervised presence of friends, relatives, neighbors, or others who have not received both criminal records clearance and training. Treatment teams determine that all out-of-home activities are appropriate for the client's level of need, including the need for supervision.

(k) Community-based resources: The treatment foster parents work with all appropriate and available community-based resources to secure services for and/or advocate for the client(s).

(a) the client's and his/her family's priorities and concerns, as appropriate, are documented; and

(b) if the client is in department custody, the agency requests information from the client's social worker, including the permanency plan, collateral assessment(s), and any known or suspected history of abuse/neglect.

(a) the identified needs of the client;

(b) the strengths of the treatment foster parents to implement the client's specific services and treatment plan;

(c) composition of the treatment foster family; including the name, age, and gender of each person residing in the home or visiting on a regular basis;

(d) treatment foster parents' specific knowledge, skills, abilities and attitudes as related to the specific needs of each client including high risk behaviors or the potential for such;

(e) treatment foster family's ability to speak the primary language of the client;

(f) treatment foster family's willingness and ability to work with the client's family;

(g) proximity of the treatment foster parent to the client's family, friends and school. If the client is placed more than an hour's driving time from the family, the justification is documented in the client's record;

(h) client and client's family's (if applicable) preference for placement;

(i) availability of, and access to, community resources required to meet the client's needs; and

(j) a summary/rationale of the client's placement in the particular treatment foster home chosen; the clinical rationale includes consideration of all residents of the home, including anticipated effects of the placement on all clients present and potential health and safety risks, and is documented in each client record prior to the placement.

(a) Prior to placement, the client's family of origin meets with his or her child's prospective treatment foster parent(s) unless clinically contraindicated, prohibited by court order, or prevented by refusal or unavailability. If a pre-placement meeting does not occur, the reasons are documented in the client's record.

(b) Following completion of the match assessment, the client visits with the treatment foster family for a full 72 hours. The dates and times of the visit are documented in the client's record. At the end of the 72 hours, the treatment coordinator documents an assessment of the visit and the the rapeutic appropriateness of the match, including the client's reaction and the treatment foster parent(s) response. When it is clinically indicated, the client may remain in the placement at the end of the 72-hour visitation, provided that the clinically-based reasons are documented in the client's record.

(c) All information that the treatment foster care services agency receives concerning a client waiting for placement is explained to the prospective treatment foster family prior to placement. Prospective treatment foster parents are responsible for maintaining agency standards of confidentiality regarding such information.

(d) For all clients in the custody of the department, the treatment foster care services agency shares the home study of a prospective licensed treatment foster family with the client's department social worker and invites the social worker to meetings in which the prospective placement is discussed.

(e) The treatment foster parent(s) can refuse placement of any treatment foster client whom they consider inappropriate for the home or to protect the safety of any children currently in the home.

(f) Treatment home composition and capacity, including capacity for therapeutic leave: Prior to any placement, the agency determines that the match is consistent with the following limits:

(g) The agency obtains written agreement of the treatment team, including Guardians ad Litem (GALs), and legal guardians, for all placements.

(h) A client with a history of more than one incident of substantiated sexual aggression may not be placed in a home with any other client, including client(s) temporarily present for therapeutic leave or shelter purposes, without prior written approval by the treatment teams of all treatment clients in the home. In the case of non-treatment minors, written permission must be obtained from the legal guardian(s) prior to such placement. The rationale for such placement will distinguish the sexually reactive from the sexually aggressive client. The sexually reactive child may have presented with a history of symptoms such as public masturbation, sex play and/or developmentally incongruent preoccupation with sexual matters or topics. This behavior by itself should not present a barrier to the placement of other children. The sexually aggressive child has had more than one incident of using force or intimidation to make another child comply with a sexual activity. The treatment team is responsible for evaluating all collateral information, evaluating any high risk behaviors or the potential for such, regardless of when it occurred or when an evaluation was performed, and the severity of the force or intimidation, regardless of how recently it occurred, prior to placing the child in a home where there are other children.

(i) The agency trains the treatment foster family in cultural and physical care issues related to the client's race and culture prior to the client's placement.

(a) Treatment foster parents providing therapeutic leave placements are licensed and trained by the agency, are given a copy of the client's treatment plan, and are supervised by the treatment coordinator in the implementation of the in-home strategies.

(b) Therapeutic leave placements may be provided by a licensed and appropriately trained treatment foster family from another licensed and certified treatment foster care services agency, provided that the placing agency ensures the client's treatment plan is implemented appropriately.

(c) It is the treatment foster care services agency's responsibility to determine that treatment foster parents into whose home a therapeutic leave client has been placed are sufficiently skilled to work with the mix of treatment clients in their home, and document this determination in their records prior to placement.

(d) If a treatment foster care services agency cannot secure a trained and licensed treatment foster care family to provide therapeutic leave for a client, the agency may place the client in a licensed residential treatment services or licensed group home services, if clinically appropriate and documented, for a period not to exceed seven days. The residential treatment services or group home services program must adhere to the client's treatment plan and document the services provided and the client's behavior, consistent with these certification requirements for treatment foster parent documentation.

(e) Therapeutic leave placements comply with all certification requirements stated herein, including capacity limits. The agency documents assessment of treatment home/family composition, physical and sexual safety issues, and language(s) spoken, prior to therapeutic leave placement.

(a) Therapy cannot be suspended or terminated unless there is concurrence by the treatment team that therapy is not presently indicated.

(b) All efforts are made to place a client in close enough proximity to biological/adoptive family so that family therapy will not be hindered.

(c) Family therapy is required when reunification is the goal.

(d) In cases where family involvement is contraindicated, the agency documents the clinical or legal basis for that determination and documents regular review of the determination.

(a) All contacts between agency staff and clients' biological/adoptive parents, and/or treatment foster parent(s) are documented in the client's records.

(b) All therapy notes are documented and placed in the client's record within one week of the session date.

(c) Therapy notes explicitly address the goals/objectives identified in the treatment plan.

(a) If any clients are currently placed in the transferring treatment home, the receiving agency will evaluate the appropriateness of the match and update the treatment plan.

(b) The receiving agency completes a new home study, or an addendum to the original home study reflecting any changes that have occurred in the composition of the home since the date of the client's admission.

(c) The receiving agency notifies the previous agency that the treatment foster parent(s) has been hired, and the previous agency, upon receipt of that notice, cancels its previous license.

(a) life skills training;

(b) education with regard to health concerns including human sexuality;

(c) vocational and technical training;

(d) housing needs during transition and after discharge;

(e) legal services;

(f) arrangements for support services, aftercare services and socialization, and

(g) cultural, religious and recreational activities, as appropriate to the client's needs.